Participatory Research in Systems of Care for Children’s Mental Health

The children’s system of care initiative in the United States requires the participation of caregivers of children with emotional or behavioral problems in conducting research and evaluation. This entails a restructuring of traditional power dynamics among families served by the community mental health system and other system stakeholders, including researchers. However, evidence indicates that system of care research may not currently embrace the different types of knowledge possessed by caregivers and may be frustrated by traditional power hierarchies, resulting in research findings that are not useful for the community. In this paper I examine a framework for power and knowledge and examine how, when viewed through this framework, participatory research in the system of care initiative thus far may be less than authentic. I conclude with improvements suggested by the framework that are expected to shift power to caregivers and result in more useful, actionable research findings for the community.     

A Tricky Object to Classify: Evidence,Postpartum Depression and the DSM‐IV

The concept of evidence has become central in Western healthcare systems; however, few investigations have studied how the shift toward specific definitions of evidence actually occurred in practice. This paper examines a historical case in psychiatry where the debate about how to define evidence was of central importance to nosological decision making. During the fourth revision of the Diagnostic andStatistical Manual of Mental Disorders a controversial decision was made to exclude postpartum depression (PPD) as a distinct disorder from the manual. On the basis of archival and interview data, I argue that the fundamental issues driving this decision were related to questions about what constituted suitable hierarchies of evidence and appropriate definitions of evidence. Further, although potentially buttressed by the evidence‐based medicine movement, this shift toward a reliance on particular kinds of empirical evidence occurred when the dominant paradigm in A merican psychiatry changed from a psychodynamic approach to a research‐based medical model.     

Liberal Rights Theory and Social Inequality: A Feminist Critique

Liberal rights theory can be used either to challenge or to support social hierarchies of power. Focusing on Ronald Dworkin's theory of rights and Catharine MacKinnon's feminist critique of liberalism, I identify a number of problems with the way that liberal theorists conceptualize rights. 1 argue that rights can be used to challenge oppressive practices and structures only if they are defined and employed with an awareness and critique of social relations of power.     

Antiegalitarians for affirmative action? When social dominance orientation is positively related to support for egalitarian social policies

Previous research has found that people high in social dominance orientation (i.e., antiegalitarians) generally oppose affirmative action policies. We propose that antiegalitarians may be less opposed to strong affirmative action policies because such policies may be perceived to ultimately strengthen racial hierarchies. Studies 1 and 2 demonstrate that antiegalitarian individuals are less opposed to affirmative action policies, as compared to egalitarian individuals, when such policies strongly weigh minority status in selection decisions. Study 3 provides evidence that antiegalitarians lessen their opposition to strong policies only when such policies are believed to enhance racial hierarchies through the recruitment of minorities that remain at the bottom of organizational hierarchies. Theoretical, political, and organizational implications are discussed.     

Names and “Doing Gender”: How Forenames and Surnames Contribute to Gender Identities,Difference, and Inequalities

Names, as proper nouns, are clearly important for the identification of individuals in everyday life. In the present article, I argue that forenames and surnames need also to be recognized as “doing” words, important in the categorization of sex at birth and in the ongoing management of gender conduct appropriate to sex category. Using evidence on personal naming practices in the United States and United Kingdom, I examine what happens at crisis points of sexed and gendered naming in the life course (for example, at the birth of babies, at marriage, and during gender-identity transitions). I show how forenames and surnames help in the embodied doing of gender and, likewise, that bodies are key to gendered practices of forenaming and surnaming: we have “gendered embodied named identities.” Whether normative and compliant, pragmatic, or creative and resistant, forenaming and surnaming practices are revealed as core to the production and reproduction of binary sex categories and to gendered identities, difference, hierarchies, and inequalities.     

SHOULD MARITAL RELATIONS BE NON‐HIERARCHICAL?

The paper explores an egalitarian norm widely accepted today, which I call the Marital Non‐Hierarchy Standard. According to this standard, marital relationships should be non‐hierarchical; neither partner may be more dominant than the other. The Marital Non‐Hierarchy Standard is exceptional: in almost all associations, including many financial, professional, educational and recreational ones, in almost all spheres of life, some hierarchies, within certain limits, are widely believed to be morally legitimate. I argue that in marital relations, too, some hierarchies should be accepted as morally legitimate. It might be argued that marital relations should be loving, and love requires that lovers will have the same degree of power. However, contemporary analyses of love show that love is consistent with (some) hierarchies. It might also be argued that justice requires that lovers will have equal power. However, theories of distributive justice such as Rawls's, Sen's, Dworkin's, and almost all others allow some marital hierarchies. Thus, both the love requirement and the justice requirement allow some hierarchical marital relationships and conflict with the Marital Non‐Hierarchy Standard. Until other justifications for this standard are presented, it is unclear why it should be endorsed.     

Toward an Evolutionary Psychology of Religion and Personality

Evolutionary psychology is an emerging paradigm for the social sciences that offers a powerful metatheoretical framework for personality psychology and, as I attempt to demonstrate in this article, for the psychology of religion as well. I argue that religion is not an evolved adaptation; rather, the diverse range of beliefs, behavior, and experience that we collectively refer to as religion emerge as byproducts of numerous, domain-specific psychological mechanisms that evolved to solve other (mundane) adaptive problems. These include mechanisms for reasoning about the natural world (naive physics and biology), about other people' minds (naive psychology), and about specific kinds of interpersonal relationships (attachment, kinship, social exchange, coalitions, status hierarchies).     

The central executive as a search process: priming exploration and exploitation across domains

The trade-off between exploration and exploitation is common to a wide variety of problems involving search in space and mind. The prevalence of this trade-off and its neurological underpinnings led us to propose domain-general cognitive search processes (Hills, Todd, & Goldstone, 2008). We propose further that these are consistent with the idea of a central executive search process that combines goal-handling across subgoal hierarchies. In the present study, we investigate 3 aspects of this proposal. First, the existence of a unitary central executive search process should allow priming from 1 search task to another and at multiple hierarchical levels. We confirm this by showing cross-domain priming from a spatial search task to 2 different cognitive levels within a lexical search task. Second, given the neural basis of the proposed generalized cognitive search process and the evidence that the central executive is primarily engaged during complex tasks, we hypothesize that priming should require search in the sense of a self-regulated making and testing of sequential predictions about the world. This was confirmed by showing that when participants were allowed to collect spatial resources without searching for them, no priming occurred. Finally, we provide a mechanism for the underlying search process and investigate 3 alternative hypotheses for subgoal hierarchies using the central executive as a search process model (CESP). CESP envisions the central executive as having both emergent and unitary processes, with one of its roles being a generalized cognitive search process that navigates goal hierarchies by mediating persistence on and switching between subgoals.     

Children First

Abstract

Investigations and prosecutions involving murdered and physically abused children are among the most serious and most complex faced by law enforcement professionals. These cases are complicated on legal, factual, medical, and scientific levels. Oftentimes, the evidence against the suspected perpetrator is solely circumstantial. Many of the problems inherent in these investigations can be overcome by prioritizing these cases. The local prosecutor's office can take the lead in ensuring justice by direct participation in the investigative phase and by ensuring continuity in the prosecution. In this article, I outline a model to ensure that this happens.     

Modesty as an excellence in moral perspective taking

I argue for an egalitarian conception of modesty. Modesty is a virtue because an apt expression of what is, and is not, morally salient in our attitudes toward persons and is important because we are prone to arrogance, self‐importance, and hero worship. To make my case, I consider 3 claims which have shaped recent discussions: first, that modesty is valuable because it obviates destructive social rankings; second, that modesty essentially involves an indifference to how others evaluate one's accomplishments; and third, the widespread but normatively fraught assumption that the modest person is deserving of credit. Although the first 2 features identify something significant about modesty, they fail to ground it. I argue that appeals to deserved credit bear a larger explanatory burden than has been supposed; they can smuggle in the illegitimate social hierarchies that modesty is supposed to counter. I make my case for modesty as an excellence in moral perspective by arguing that prominent, nonegalitarian, accounts of modesty allow for or promote illegitimate forms of social privilege. Modesty is valuable because it expresses a commitment to fair distribution of basic moral recognition and a skillful response to unjust social hierarchies at odds with this fair distribution.     

医学生之医学伦理素养教育剖辨

对医学生加强医学伦理素养教育是当前国内外医学教育的共识,但在教育的内容、方式和方法上却是各具特色.相对而言,我国医学院校对医学生的医学伦理素养教育尚处于不成熟的阶段,其表现就是教育过程中存在着诸多的问题、教学效果不甚理想.从医学伦理素养教育的现状入手,尝试分析我国医学伦理素养教育中的重点和难点问题.     

Unconscious Evidence

Can beliefs that are not consciously formulated serve as part of an agent's evidence for other beliefs? A common view says no, any belief that is psychologically immediate is also epistemically immediate. I argue that some unconscious beliefs can serve as evidence, but other unconscious beliefs cannot. Person‐level beliefs can serve as evidence, but subpersonal beliefs cannot. I try to clarify the nature of the personal/subpersonal distinction and to show how my proposal illuminates various epistemological problems and provides a principled framework for solving other problems.     

Informal Hierarchy and Team Creativity: The Moderating Role of Empowering Leadership

Although there is growing evidence that strong informal influence hierarchies can enhance teams' core task performance, recent theorising suggests that such informal hierarchies may, at the same time, stifle team creativity. The current study draws from the Motivated Information Processing in Groups (MIP-G) model to empirically examine this latter notion. Moreover, we build on functional leadership theories to propose that the link between informal hierarchy strength and team creativity hinges on a formal team leader's empowering leadership. Using a sample of 56 organisational work teams comprising 304 individuals from a wide range of industries, we found that stronger informal influence hierarchies related negatively with team creativity when the formal leader exhibited little empowering behaviour. When the formal leader acted in more empowering ways, by contrast, this negative relationship was dampened. These findings provide new knowledge on the role of informal influence hierarchies for team creativity and advance our understanding of how informal hierarchical relations and formal leadership processes can jointly shape important team outcomes.     

Combinations of tense and deontic modality: On the approach to temporal logic with historical necessity and conditional obligation

We consider three infinite hierarchies of what I call “two-dimensional temporal logics with explicit realization operators”, viz. (i) one without historical or deontic modalities, (ii) one with historical but without deontic modalities, and (iii) one with historical and with dyadic deontic modalities for conditional obligation and permission. Sound and complete axiomatizations are obtained for all three hierarchies relative to a simplified version of the finite co-ordinate-system semantics given for so-called T × W logic of historical necessity in [L. Åqvist, The logic of historical necessity as founded on two-dimensional modal tense logic, J. Philos. Logic 28 (1999) 329–369].     

Non‐Ideal Theorizing,Social Groups,and Knowledge of Oppression: A Response

In responding to Anderson, Tobin, and Mills, I focus on questions about non‐ideal theory, normative individualism, and standpoint theory. In particular, I ask whether feminist theorizing can be “liberal” and yet not embody the problematic forms of abstraction and individualism described in Challenging Liberalism. Ultimately, I call for methods of theorizing that illuminate and challenge oppressive social hierarchies.     

Heuristics in medical and non-medical decision-making

Pairs of hypothetical medical and non-medical problems were given to 44 pediatric residents at three levels of hospital training. Each problem was designed to detect a specific heuristic-based bias in making diagnoses. Discounting, disregarding base rate, and over-confidence in contextually embedded redundant information were more evident on medical than on non-medical problems. In particular, a greater number of third-year residents disregarded base-rate information than did first- and second-year residents on medical but not on non-medical problems. On medical problems, a greater number of first-year residents expressed greater confidence in redundant information that was contextually embedded than in information that was presented in a listed format. Over one-third of the residents confused prospective and retrospective probabilities; three-fourths showed evidence of augmentation; virtually all residents expressed greater confidence in a diagnosis based on redundant rather than on non-redundant listed information. These latter effects were consistent across training level and occurred on both medical and non-medical problems. The results are discussed in terms of prototype theory and the nature of medical training.     

Infiltrating the curriculum: An integrative approach to history for medical students

I believe that the purpose of history in a medical school can be related to two simple goals: first, to make students a bit skeptical about everything else they are to be taught in the other lectures--skepticism fosters humility and life-long learning; second, to make them aware that medical history is a research discipline as compelling as any of the basic and clinical sciences they are traditionally taught. In the fall of 1988, I was given an opportunity to build a "course" in history for medical students--a course with no fixed time slot, no fixed syllabus, and no fixed content. I wanted to teach history of anatomy during anatomy sessions, history of pathology during pathology, history of obstetrics during obstetrics, and so on. I hoped to end each session with a disciplinary controversy that extended into present practice. The ultimate manifestation of infiltration would be to have one question on every exam that the students would write during their medical school experience. This is the story of how my medical history teaching moved from nothing to a program integrated throughout four years of medical studies, complete with goals and objectives and two questions of every exam. The content, advantages, and problems of the approach in the Queen's University experience will be presented.     

Commodification and commercial surrogacy

... In this article I shall argue tentatively for the claim that commercial surrogacy should be legally permissible. I am more strongly convinced that a commitment to feminism should not predispose anyone against surrogacy. At least, no arguments offered so far should persuade anyone who is committed to equal rights for women and men and the dismantling of gender-based hierarchies to favor either legal prohibition or moral condemnation of commercial surrogacy.     

Dominance Hierarchies and Health: Constructing Personal Zones of Spiritual Power and Healing in Modern Medicine

Ethological studies of animals in groups and sociobiology indicate that hierarchies of dominance amongst some species ensure the survival of the group. When transferred to human groups, dominance hierarchies suggest a crucial role played by recasting the scope of such hierarchies of dominant and subordinate members to included “hyper-dominant beings.” A recognition of such beings as even more dominant than the socially dominant members of a hierarchy facilitates the empowerment of the socially subordinate members. Religious belief and practice works to establish such hyper-dominant beings (“gods,” “goddesses,” and so forth) as superior members of human groups. Doing so is a means of ensuring the survival of the species and, thus, enhancing healing and human health. The “doctor–patient” relationship is examined from such a point of view, with an emphasis on whether the hierarchy created by the relationship allows consideration of alternative and complementary forms of medical treatment.     

Tonal hierarchy representations in auditory imagery

Two experiments investigated psychological representations of musical tonality in auditory imagery. In Experiment 1, musically trained participants heard a single tone as a perceptual cue and built an auditory image of a specified major tonality based on that cue; participants’ images were then assessed using judgments of probe tones. In Experiment 2 participants imaged a minor tonality rather than a major one. Analysis of the probe tone ratings indicated that participants successfully imaged both major and minor tonal hierarchies, demonstrating that auditory imagery functions comparably to auditory perception. In addition, the strength of the major tonal image was dependent upon the pitch and tonal relations of the perceptual cue and the to-be-imaged tonality. Finally, representations of minor tonal hierarchies were less robust than those of major ones, converging with perceptual evidence that minor tonalities are less psychologically stable than major tonalities.